Haemorrhoids: A Practical Checklist

Swollen blood vessels in and around the anus, commonly called piles. They are very common and usually settle with simple measures, and the danger is assuming any rectal bleeding is them.

Key takeaways

• Typical symptoms: bright red bleeding on wiping, itching, discomfort, a lump
• Main contributor: straining and constipation
• Most useful single change: Treat constipation; it is the underlying cause for most people.
• Commonest mistake: Assuming all rectal bleeding is piles.
• See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

Do

• Treat constipation; it is the underlying cause for most people
• Avoid straining and do not sit on the toilet for long periods
• Use a footstool to raise the knees above the hips
• Keep the area clean and dry

Do not

• Assuming all rectal bleeding is piles
• Long-term use of topical steroid preparations without advice
• Prolonged straining or reading on the toilet

The numbers behind the list

Every item above comes from these figures, published in the guidance listed at the foot of the page.

If you change one thing

Treat constipation; it is the underlying cause for most people. If you only change one thing, make it that.

Where to go next

• Myths About Haemorrhoids, Checked Against the Guidance
• The First Steps With Haemorrhoids
• Haemorrhoids — the reference entry
• Food Intolerance: What the Evidence Actually Says
• What the Guidance Really Says About Probiotics

When to speak to a doctor

See a GP for any rectal bleeding, particularly if it is dark, mixed with stool, persistent, or accompanied by a change in bowel habit, weight loss or abdominal pain — bowel cancer can present identically to piles. Seek urgent help for severe anal pain with a hard lump, or heavy bleeding with dizziness.

Where this comes from

• NICE — Haemorrhoids clinical knowledge summary
• NHS — Piles

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.